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With one in five American adults afflicted, arthritis costs the nation $128 billion annually. Its growth is accelerating as the baby boomers age and people of all ages become heavier, fueling the disease.

Yet public health experts say it's hard to persuade people to take this painful, costly condition seriously.

"Arthritis is seen as not a killer," said Dr. Patience White, vice president of public health at the Arthritis Foundation. "What they don't know is that disability is a killer in the long run."

More than half of adults with diabetes or heart disease also have arthritis. Physical activity is one of the first things doctors recommend to manage all of these conditions. But people with arthritis are typically less active than those without.

Arthritis, White explained, is what's called a "doorknob disease," a medical problem that patients often consider so insignificant they don't bring it up until the doctor's hand is on the examining room door.

The word "arthritis" actually can describe more than 100 conditions affecting the joints, including fibromyalgia, lupus and gout. In the most common type, osteoarthritis, the cartilage and bone at the joint gradually wear down, a process worsened by age, weight and inactivity.

The toll of arthritis is making headlines. In just the past week:

• Some of the most prestigious medical groups in the country, including the Mayo Clinic and the Cleveland Clinic, announced they are sharing data to determine the highest-quality, lowest-cost ways to approach the most common and costly procedures and conditions. First up: knee replacements — usually due to arthritis — which are performed more than 300,000 times a year in the United States with costs that range from $16,000 to $24,000 per surgery.

• Although doctors have been giving older arthritic patients narcotic painkillers, thinking they're safer than non-narcotics such as Advil, a new study in the Archives of Internal Medicine found those on narcotics face a higher risk of bone fracture, heart attack and death.

• A new study in the Journal of Gerontology says that we are spending more of our final years in poor health, including a marked increase in the number of people who can't walk up stairs or stroll a quarter-mile. "There is substantial evidence that we have done little to date to eliminate or delay disease or the physiological changes that are linked to age," researchers from the University of Southern California wrote.

But the U.S. health care system, in which providers are paid for procedures, encourages doctors to order up drugs, tests and surgery rather than spend time motivating patients to make difficult lifestyle changes.

Physicians "just don't have enough time, said Jennifer Hootman, an epidemiologist in the arthritis program at the Centers for Disease Control and Prevention. Plus, she said, doctors and patients alike are often unaware of resources offered by groups such as the Arthritis Foundation (see box for contact information). "Most of them don't know that there are programs in their community that could help them that are very low cost."

Given the impact arthritis has on people's lives, she said, patients say they would take action if they knew how.

"They would be willing to go to them," she added. "But they just don't know about them."

Information from Times wires was used in this report.

By the numbers

50 million: American adults who suffer from some form of arthritis

1 million: People who develop arthritis every year

No. 1: Arthritis' rank among all causes of disability

One in two: Adults who will eventually develop osteoarthritis of the knee

Two in three: Obese adults who will eventually develop osteoarthritis of the knee

More than half: Adults with diabetes or heart disease who also have arthritis